Woodeaves Residential Care Home

We found the following examples of good practice.

¿ Visitors were screened for symptoms of COVID-19. This included having their temperature taken, along with LFD (Lateral Flow Device) testing to ensure visits could take place safely. PPE was provided and a pod had recently been installed to support screened visits.

¿ The provider updated their visiting policy during our inspection to incorporate recent changes to government guidance in relation to indoor visiting. This meant they were facilitating visits to people living at the home in accordance with current guidance.

¿ People living at the home and staff were supported to take part in regular testing and had access to the vaccination programme. Staff carried out a LFD test prior to the start of each shift.

¿ There were COVID-19 specific policies and risk assessments to guide staff on the appropriate actions to reduce the risk of transmission. The home had not experienced an outbreak of COVID-19.

¿ Staff had worked extra shifts to reduce the requirements for agency staff to come into the home. During the earlier part of the pandemic the deputy manager had moved into the home for a period of five months, to provide staffing back up and support.

¿ The home was clean and hygienic. There were schedules in place to ensure frequent cleaning took place, with increased cleaning of frequently touched surfaces to reduce the risk of transmission of infection.

Woodeaves Residential Care Home (Woodeaves) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is located in a residential area on the outskirts of Nantwich and covers three floors connected by a passenger lift, a stair lift and stairs. Communal facilities include two lounges and one dining room which are located on the ground floor. Woodeaves could accommodate up to 22 people. At the time of the inspection there were 20 people living at the home. This was because two of the rooms could be occupied on a shared basis but were currently occupied as single accommodation.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People continued to receive a safe service. Processes were in place to minimise the risk of harm. Accidents and incidents were recorded and there was management oversight to identify emerging trends. Detailed risk assessments were completed and regularly reviewed. Safe recruitment practices were employed by the home. Medicines were managed and administered safely. People told us staff came quickly when they needed them and that there were sufficient staff to meet their needs.

Staff were aware of the need to report concerns in order to protect people from abuse. However, there had been a delay in reporting an allegation to management. This was brought to the attention of the deputy manager on the first day of inspection and the correct process was then followed.

People received a service that was not consistently effective. This was because mental capacity assessments were carried out routinely for all people living at Woodeaves, rather than in line with the principles of the Mental Capacity Act 2005. This practice had been introduced as a requirement from a monitoring visit by the local authority and, although not appropriate, had not been questioned by the registered manager.

A person’s care plan had not been updated and was not reflective of their current needs which left them at risk of receiving care that was not effective. We observed there were long periods without staff interaction although they exhibited symptoms of anxiety. When we made the deputy manager aware of our concerns action was taken immediately to address whilst further liaison with a specialist team took place.

Staff received regular supervision and appraisal, their competency was regularly checked and they had access to a wide range of training.

The provider had introduced an electronic care management system since the last inspection. The registered manager informed us that there was still an element of “embedding in” for the most effective use. We saw that staff did not always carry the hand-held devices used for recording interventions at the point of delivery.

People continued to receive a service that was caring. People told us that staff were kind and gentle and we observed some caring and patient practice. The service had achieved a score of 9.8 out of ten from 33 reviews on a website which allows people who use, have used or have a relative who has used the service to leave a review. People were treated as individuals, treated fairly and without discrimination with consideration to religious and cultural beliefs. People communication needs were considered and recorded.

People continued to receive a service that was responsive. People’s needs were assessed before they came to live at Woodeaves to ensure they could be met. Each person had a personalised plan of care. People’s future wishes for end of life care were considered. People and relatives had been involved in these processes.

There was a process to receive and respond to complaints. No complaints had been recorded since 2014. “Informal” complaints, for example about laundry, which had not required a written response had not been recorded. The registered manager was to introduce a new recording system to ensure that there is an ongoing record of all complaints, concerns and compliments.

People had access to a range of activities. People told us that they were offered choice, for example about when to get up and/or go to bed. Although some people were happy with the frequency of baths or showers, some people identified a more structured approach.

People received a service that was well-led. The registered manager was supported by a deputy manager. The registered manager was aware of their responsibilities of their registration with the CQC and had informed us about important events as required by law. The latest CQC rating was displayed within the home and on the provider’s website.

Records were well organised, readily available and securely stored. People living at Woodeaves, their relatives and staff could express their views in a variety of ways including surveys and meetings. We received some feedback that when concerns were raised, nothing had been done about them. Some staff were reluctant to raise issues for fear of repercussions. We discussed these comments with the registered manager during the inspection.

The registered manager and deputy manager were open to discussion and acted to address areas raised during the inspection, this promptly. The deputy manager demonstrated a genuine passion to continuously improve the service to deliver outstanding care.

The home was last inspected on 14 January 2014 and was meeting the required standard.

Woodeaves is a large detached Victorian house and is registered to provide accommodation for 22 people who require nursing or personal care. The home is located in a residential area on the outskirts of Nantwich. The home has twenty bedrooms. Communal facilities include two lounges and a dining room which are located on the ground floor. There is a small secluded garden area to the rear of the home. The home has a passenger lift to access the first and second floor and the majority of the bedrooms, four ground floor bedrooms are available.

The home had a Registered Manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People’s needs were assessed and care plans identified people’s needs whilst fostering and maintaining independence where possible.

Some people who used the service did not have the ability to make decisions about some aspects of their care and support. Staff had an understanding of the systems in place to protect people who lacked capacity to make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

Staff were knowledgeable about the risks of abuse and the reporting processes.

We found that the storage, administration and disposal of medications was safe.

The organisation had thorough recruitment practices so that suitable staff were employed.

Staff received suitable induction and training to meet the needs of people living at the home. Staff were well supported by the manager. This meant people were being cared for by suitably qualified, supported and trained staff.

There were systems and processes in place to monitor the quality of the service and address shortfalls.

Comments from the people who lived at Woodeaves included:

'I've been here for three years in February and had no problems at all'.

'In the main yes, I'm happy. The staff are pleasant, food is good, it's clean, quite pleasant atmosphere'.

There were 19 people who currently lived at the home. We observed interaction between the people who lived at Woodeaves and the staff on duty and it was clear that their needs were well known to staff. It appeared that people living there were happy and content and they were given the support they needed.

One of the relatives we spoke with told us they had chosen if for their relative because 'we found it friendly and homely'.

We asked staff what it was like working at Woodeaves and one of the care workers we spoke with told us 'I love working here 'I love the people'.

We looked at staff personal files and found that people who lived at the home were protected because appropriate checks were undertaken before staff were recruited and the people we spoke with who lived at Woodeaves told us they felt safe there and felt staff knew what they were doing.

We spoke to people having their lunch and they told us that the food was "always very good" and "always plenty of it". We asked one person what they had had for lunch and they told us in detail and that it was "very nice".

We spoke to a family member and they told us that they were "very pleased with the home". We viewed records to ensure that people's care and support was being delivered in accordance with personal care plans and that equipment which was beng used to support people and promote their independence was used safely and properly maintained.